Healthcare Provider Details

I. General information

NPI: 1497669931
Provider Name (Legal Business Name): CREWS DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 S BRENTWOOD BLVD STE 202
WEBSTER GROVES MO
63119-1780
US

IV. Provider business mailing address

3205 S BRENTWOOD BLVD STE 202
WEBSTER GROVES MO
63119-1780
US

V. Phone/Fax

Practice location:
  • Phone: 314-961-3244
  • Fax:
Mailing address:
  • Phone: 314-961-3244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. TYLER CREWS
Title or Position: OWNER
Credential: DMD
Phone: 314-961-3244